The Nation

Doctor Defrauds Free Vaccination Program

HARTFORD, Conn. — A pediatrician pleaded guilty in federal court Thursday to billing private insurance companies and Medicaid for children's vaccines that she had received free through a government-subsidized program.

U.S. Atty. Kevin O'Connor said that Suvarna Shah, who practices in Norwalk, Conn., was the first doctor in the United States to be charged with fraud in connection with the decade-old Vaccines for Children Program. The federal and state governments fund the program to ensure that all children receive the vaccines they need without concern for cost.

O'Connor and state Atty. Gen. Richard Blumenthal strongly suggested that Shah would not be the only doctor charged.

"The problem is more prevalent than just a single person," Blumenthal said. "It's my expectation there will be other prosecutions shortly."

Shah, 62, who was born and educated in India, has been practicing medicine in the United States since 1974.

In addition to the healthcare fraud violation, she was convicted of income tax evasion and faces up to 10 years in prison and $350,000 in fines when sentenced Aug. 6. She "most likely" will be deported to India once her penalty has been served, U.S. District Judge Christopher F. Droney said.

Her lawyer, William Bloss, said her patients would suffer the loss of her services.

"The shame of it is, she has delivered 30 years of high-quality care to the poorest people of Norwalk," he said.

Oxford Health Plans had detected Shah's fraudulent billing in January 2002, and sent her a letter demanding reimbursement of funds it had paid to cover vaccinations.

Shah not only refused to repay Oxford, but also continued to fraudulently bill Medicaid and private insurers a total of $17,647 for vaccinations during the balance of 2002, Assistant U.S. Atty. David Sheldon said.

"The arrogance of these actions was absolutely staggering," Blumenthal said. "She'd been detected in effect by Oxford and asked to return the money and refused, and continued to bill the other providers."

Shah, who lives in Westport, was released on $100,000 bail to await sentencing and surrendered her passport to federal officials after Thursday's hearing.

The income tax evasion charge was not directly related to the healthcare fraud. Sheldon said investigators learned that Shah kept two sets of financial ledgers and had been skimming off cash receipts and not reporting those on her individual or corporate income tax returns.

Shah has agreed to pay about $1.2 million to cover back taxes, penalties and restitution, including double the approximately $150,000 she bilked from the Medicaid program. Her fraudulent billings totaled more than $350,000 from 1997 through 2002.

O'Connor said the government already is holding more than $700,000 of Shah's money, which was seized from a safe deposit box.

Blumenthal and O'Connor stressed that no child was harmed by Shah's actions.